This study was carried out to examine the association of age, nutrient intake, alcohol drinking and smoking on serum lipid and apolipoprotein levels in 100 healthy adults (54 males and 46 females). The serum total cholesterol, low density lipoprotein cholesterol (LDL-C) (p<0.05), apolipoprotein B (Apo B) levels, LDL-C:high density lipoprotein cholesterol (HDL-C) ratio, Apo B:apolipoprotein(Apo A-I) ratio and atherogenic index (AI) (p<0.001) were significantly higher in males than females, but HDL-cholesterol level was significantly lower (p<0.01) in males than females. The plasma ascorbic acid concentration had no difference in both genders. Most of nutrient intakes except Ca, vitamin A and vitamin $B_2$ were higher than RI (Recommended intake) in both males and females. The meal frequency per day was significantly higher (p<0.01) in males than females, while meal speed, the heaviest meal, meal quantity and meal regularity had no significant differences. The rates of drinking and smoking were significantly higher (p<0.01) in males (59.3%, 37.2%) than females (17.3%, 6.9%). The age was positively correlated with triglyceride level in males (p<0.05), and with total cholesterol (p<0.001), LDL-cholesterol (p<0.001), Apo B (p<0.01), LDL-C:HDL-C ratio (p<0.01), Apo B:Apo A-I ratio (p<0.05) and AI (p<0.01) in females. The levels of serum lipid and apolipoprotein were more correlated with protein intake than other macronutrient intakes in males, while those in females were more correlated energy, carbohydrate and lipid intakes than protein intake. The effect of drinking on serum lipid and apolipoprotein levels was bigger in males than females, while the effect of smoking on those was bigger in females than males. The plasma ascorbic acid concentration was positively correlated with HDL-cholesterol (p<0.05), Apo A-I levels (p<0.001), whereas negatively correlated with Apo B:Apo A-I ratio (p<0.05) in males. And that was positively correlated with HDL-cholesterol (p<0.05) in females. These results suggest that moderate macronutrient intake, less alcohol consumption and non-smoking were necessary to maintain healthy lipid profile with aging in adults.
In the 2020 Dietary Reference Intakes for Koreans, an acceptable macronutrient distribution range (AMDR), similar to the one established in 2015, was determined for carbohydrates. AMDR is the ratio that signifies energy intake from carbohydrates to the total energy intake, and is a reference that indicates a decreasing risk of chronic diseases. The AMDR of carbohydrate was determined to be optimal at 55-65% for all ages above 1 year. For the first time, in the year 2020, the estimated average requirement (EAR) and recommended nutrient intake (RNI) for carbohydrates were established. The EAR was based on the amount of glucose used per day in the brain, and was set at 100 g/day for all ages above 1 year. The RNI was set at 130 g/day, by adding a double coefficient of variation using a 15% coefficient of variation, for all ages above 1 year. In pregnant women, the amount of glucose utilized by the fetus brain was considered additionally, and for lactating women the amount of lactose secreted into maternal milk was additionally taken into consideration. Since the EAR of carbohydrate indicates the minimum amount of glucose required by the brain and is not an appropriate intake amount as an energy source, it is incorrect to compare the carbohydrate intake with the EAR or RNI. To evaluate the nutritional status of carbohydrate, it is appropriate to use the AMDR. Carbohydrate intakes within the AMDR range has the possibility in reducing the risk of chronic diseases. Hence, it is important to consider the quality as well as quantity of carbohydrates consumed.
Objectives: This study aimed to evaluate dietary protein intake and its adequacy among Korean adults during recent 10 years. Methods: Based on the 2010 ~ 2019 Korea National Health and Nutrition Examination Survey (KNHANES) data, a total of 51,296 adults aged 19 years old or more who participated in a one-day 24-hr dietary recall were included. Dietary protein intake was estimated as percentages of total energy (% of energy) and grams per body weight (g/kg/day) and compared with the 2020 Dietary Reference Intakes for Koreans to evaluate the adequacy of protein intake. In addition, proportions of people whose protein intakes were less than the estimated average requirement (EAR) and above the upper limit of the acceptable macronutrient distribution range (AMDR) (> 20% of energy) were calculated according to sociodemographic characteristics. Results: Protein intake was increased from 14.7% of energy in 2010 to 15.6% of energy in 2019 among Korean adults. However, there was no increase in protein intake relative to the recommended nutrient intake (% RNI) during the recent 10 years. Protein intake relative to the RNI was decreased from 130.2% in 2010 to 121.1% in 2019 (P for trend < 0.0001) among total participants, and a significant decreasing trend was observed in all age groups except for over 65 years old. However, protein intake relative to the RNI was lowest in the elderly (98.6%). Proportions of low protein intake (< EAR) and high protein intake (> AMDR) increased in the past 10 years (P for trend < 0.0001 for all), and these were associated with socioeconomic statuses, such as education and household income levels. Conclusions: These findings suggest that protein adequacy in Korean adults has not been improved over the past decade compared with recommended levels. Nutritional education and intervention programs should consider different intake levels according to sociodemographic characteristics.
The purpose of this study was to investigate the effects of gender on the thermic effect of food and substrate oxidation rate during 5 hours after a mixed meal. Twenty healthy college students (10 males and 10 females) aged 20-26 years participated in this study. The energy contents of the experimental diets were 775 kcal and 627 kcal for males and females respectively, which were 30% of individual energy requirements and were composed of 65/15/20% as the proportion of carbohydrate/protein/fat. Resting and postprandial energy expenditure and substrate oxidation rates were measured with indirect calorimetry in the fasting state and every 30 min for 5 hours after meal consumption. Thermic effects of food expressed as ${\Delta}AUC$ and TEF% were not significantly different between males and females. However, TEF% adjusted for body weight and fat-free mass in males (0.095% and 0.120%) were significantly lower than those in females (0.152% and 0.213%)(p < 0.05). The total amount of carbohydrate oxidized was significantly lower in males than that in females (58.6 vs. 86.6 mg/kcal energy intake/5 h, p < 0.05). In contrast, the total amount of fat oxidized was significantly higher in males than that in females after the meal (32.9 vs. 17.2 mg/kcal energy intake/5 h, p < 0.01). These results indicate that gender affects the thermic effects of food and the substrate oxidation rate after a meal. The results show that males use relatively less carbohydrate and more fat as an energy source after a meal than that of females.
Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G${\rightarrow}$T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G${\rightarrow}$T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.
This study assessed the nutrient intake for Korean adolescents using the estimated usual intake. The usual intake of 1,763 adolescents aged 12-17 years old was estimated from one-day 24-hour recall data in the 2010-2012 Korean National Health and Nutrition Survey. The nutrient intakes of four groups according to sex (male and female) and age (12-14 and 15-17 years old) were then assessed in reference to the 2015 Dietary Reference Intakes for Koreans. For macronutrients, the proportions of subjects below and above the Acceptable Macronutrient Distribution Ranges (AMDR) were calculated. The Estimated Average Requirement (EAR) cut-point method was used to assess insufficient intakes of protein, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, and iron; the full probability approach was used to assess the insufficient intake for iron among females. The proportions of subjects over the Tolerable Upper Intake Levels for vitamin C, niacin, calcium, phosphorus, and iron and the proportions over the Intake Goal for sodium were calculated to assess excessive intake. The proportions of subjects above AMDR for carbohydrates ranged from 22.5% to 38.0% by group. The proportions of subjects by group with insufficient intake for vitamin C, riboflavin, calcium, phosphorus, and iron ranged 29.1-39.7%, 22.5-34.3%, 73.1-89.3%, 14.3-43.6%, and 23.2-55.5%, respectively. The proportions of subjects by group with excessive intake for sodium ranged from 91.5% to 99.3%. The results of this study represent important basic information to establish nutritional standards for school lunches as well as to decide on relevant nutrition policies for adolescents.
Sugars are a ubiquitous component of our food supply and are consumed as a naturally occurring component of many foods and as additions to foods during processing, preparation, or at the table. Most fruits and dairy products are high in sugars and thus naturally occurring sugars are consumed as part of a healthy diet. Some countries developed recommended daily intake figures(daily values : DVs or guideline daily amounts: GDA) for nutrients, and some countries, but not most have developed DV/GDA for total sugars. Dietary Reference Intakes for Koreans established by the Korean Nutrition Society in 2005, did not include the reference values for total sugar or added sugar. The committee on Dietary Reference Intakes for sugar was constituted in 2006 and discussed whether to special added sugars or total sugar. Although added sugars are not chemically or physiologically different from naturally occurring sugars, many foods and beverages that are major sources of added sugars have lower micronutrient densities compared with foods and beverages that are major sources of naturally occuring sugars. But it was so hard to calculate a dietary intake of added sugar for Korean people, because there was insufficient information about contents of added sugar during processing or preparation of Korean food. Currently Korean or US food labels contain information on total sugars per serving but do not distinguish between sugars naturally present in food and added sugars. Therefore the committee decided to set the reference value for total sugar for Koreans. According to the recommended diet pattern for Koreans suggested by the Korean Nutrition Society, estimated sugar intake from the sugar containing food based on 2,000 kilocalories is 67 g or 13% of total energy. Based on the data available on risk of obesity, hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome from the analysis of Korean NHANES, it was insufficient evidence to set a UL for total sugar, but tended to increase serum LDL cholesterol and obesity at over 20-25% of energy from total sugar when consumed with high carbohydrates. Therefore the committee on Dietary Reference Intakes for sugar set the Acceptable Macronutrient Distribution Range for total sugar as 10-20% of total energy intake.
Kim, Dong-Woo;Shim, Jae-Eun;Paik, Hee-Young;Song, Won-O;Joung, Hyo-Jee
Nutrition Research and Practice
/
v.5
no.3
/
pp.266-274
/
2011
Accurate assessment of nutrient adequacy of a population should be based on usual intake distribution of that population. This study was conducted to adjust usual nutrient intake distributions of a single 24-hour recall in 2001 Korean National Health and Nutrition Surveys (KNHNS) in order to determine the magnitude of limitations inherent to a single 24-hour recall in assessing nutrient intakes of a population. Of 9,960 individuals who provided one 24-hour recall in 2001 KNHNS, 3,976 subjects provided an additional one-day 24-hour recall in 2002 Korean National Nutrition Survey by Season (KNNSS). To adjust for usual intake distribution, we estimated within-individual variations derived from 2001 KNHNS and 2002 KNNSS using the Iowa State University method. Nutritionally at risk population was assessed in reference to the Dietary Reference Intakes for Koreans (KDRIs). The Korean Estimated Average Requirement (Korean EAR) cut-point was applied to estimate the prevalence of inadequate nutrient intakes except for iron intakes, which were assessed using the probability approach. The estimated proportions below Korean EAR for calcium, riboflavin, and iron were 73%, 41%, and 24% from usual intake distribution and 70%, 51%, and 39% from one-day intake distribution, respectively. The estimated proportion of sodium intakes over the Intake Goal of 2,000 mg/day was 100% of the population after adjustment. The energy proportion from protein was within Korean Acceptable Macronutrient Distribution Ranges (Korean AMDR), whereas that of carbohydrate was higher than the upper limit and that of fat was below the lower limit in the subjects aged 30 years or older. According to these results, the prevalence of nutritional inadequacy and excess intake is over-estimated in Korea unless usual intake distributions are adjusted for one-day intakes of most nutrients.
The purpose of this study was to establish an association between the percent of energy from total sugar and disease prevalence of obesity, hypertension, dyslipidemia, insulin resistance, and metabolic syndrome with the context of the current population dietary practice in Korea. The Korean National Health and Nutrition Survey, 2001 and 2002 dataset were used as the source of data for this research. Usual nutritional intakes for over 20 years old people were calculated from the two non-consecutive dietary intake data from KNHANES 2001 and 2002 dataset. SAS and SUDAAN were used for statistical analyses. Sample weighted means, standard errors, and population percentages were calculated, and multiple logistic regression model with adjustment for covariates were used to determine the odds ratios(ORs) and 95% confidence intervals. Subjects were categorized as 3 ways and compared the LS means and ORs for heath factors. First, subjects excluding pregnant women, were categorized according to percent of energy from the usual total sugar intakes as ${\leq}10%$, 11-15%, 16-20%, 21-25%, >25%. Risk of LDL cholesterol showed a tendency to increase in the '>25%' group compared to the '<10%' group. The risks of the other health effects did not show any significant differences. Second, the subjects were categorized considering both Acceptable Macronutrient Distribution Range(AMDR) from carbohydrate and %Energy from total sugar as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-25%', and '$CHO{\geq}70%$ & Total sugar ${\geq}25%$'. The risk of obesity tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}25%$' group compared to the 'CHO<55% & Total sugar ${\leq}10%$'. Third, the subjects were categorized as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-20%', and '$CHO{\geq}70%$ & Total sugar ${\geq}20%$'. The risk of obesity also tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}20%$' group compared to the 'CHO<55% & Total sugar ${\geq}20%$' group. In conclusion, risk of LDL cholesterol showed a tendency to increase in the over 25% total sugar intake group, and the risk of obesity tended to increase in the 20-25% total sugar intake and high carbohydrate intake group. The risks of hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome were not associated with total sugar intakes. More research to elucidate the association for Korean between the intakes of total sugar, added sugar, glucose, fructose, and sweeteners and diseases prevalences shoud be excuted in the future.
This study assessed the current EAR, RDA, and AMDR for protein, which were set in 2005 and revised in 2010 as the DRIs for Koreans. A classical approach to establish the EAR for protein has been the nitrogen balance method. This method has practical limitations and problems in statistical analysis by giving over estimations of nitrogen balance. Thus, the present EAR for protein might be lower than the true requirement. Recent reevaluations of nitrogen balance studies by bilinear regression analysis and the IAAO method have indicated that the EAR of 0.66 g/kg bw/d should be increased by 39% to give 0.92 g/kg bw/d. The AMDR for protein in the Korean DRIs was set at 7-10%, which covers almost the entire population's protein intake. Since the 5th percentile of Korean protein intake is close to 10% of energy and due to the beneficial effects of protein beyond the maintenance of nitrogen equilibrium, the lower range of 7% needs to be increased up to 10%. For practical meal arrangement, 15% of energy as protein, which is close to the average protein intake of Koreans, seems to be proper, although the value is almost two times the EAR.
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